How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,096 to $10,000Professionalmedian $1,230 · 10th to 90th $955 to $1,905
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $1,819.70 | Facility | None | $1,148.15 | $1,445.44 | $1,819.70 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,148.15 | $1,445.44 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $11,748.98 | Facility | None | $1,202.26 | $3,467.37 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,584.89 | Professional | None | $933.25 | $1,122.02 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $181.97 Typical High $251.19 | Professional | 80 · Assistant surgeon | $147.91 | $181.97 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $158.49 Typical High $218.78 | Professional | AS · PA/NP assist | $128.82 | $158.49 | $218.78 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $1,737.80 Typical High $4,897.79 | Facility | None | $1,047.13 | $1,737.80 | $4,897.79 |
CareSource Setting Professional Modifier None Typical Low $977.24 Median $1,513.56 Typical High $1,778.28 | Professional | None | $977.24 | $1,513.56 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $3,630.78 | Facility | None | $1,288.25 | $2,511.89 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $7,762.47 | Professional | None | $1,096.48 | $1,513.56 | $7,762.47 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,230.27 | $1,621.81 | $2,454.71 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $575.44 Median $707.95 Typical High $912.01 | Facility | 52 · Reduced service | $575.44 | $707.95 | $912.01 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $229.09 Median $288.40 Typical High $363.08 | Facility | 53 · Discontinued | $229.09 | $288.40 | $363.08 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $851.14 Median $1,071.52 Typical High $1,348.96 | Facility | 54 · Surgery only | $851.14 | $1,071.52 | $1,348.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $169.82 Median $213.80 Typical High $269.15 | Facility | 55 · Aftercare only | $169.82 | $213.80 | $269.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $114.82 Median $144.54 Typical High $181.97 | Facility | 56 · Pre-op care only | $114.82 | $144.54 | $181.97 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,000.00 Typical High $1,258.93 | Facility | 78 · Unplanned return to OR | $794.33 | $1,000.00 | $1,258.93 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $575.44 Median $707.95 Typical High $912.01 | Professional | 52 · Reduced service | $575.44 | $707.95 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $288.40 Typical High $363.08 | Professional | 53 · Discontinued | $229.09 | $288.40 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,071.52 Typical High $1,348.96 | Professional | 54 · Surgery only | $851.14 | $1,071.52 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $213.80 Typical High $269.15 | Professional | 55 · Aftercare only | $169.82 | $213.80 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $144.54 Typical High $181.97 | Professional | 56 · Pre-op care only | $114.82 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,000.00 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $794.33 | $1,000.00 | $1,258.93 |
Where Kentucky sits
The same service costs 5.2 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Kentucky· 48th of 51
$1,288
AK $6,026TX $1,148
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.